Mary A. Ott

Permanent URI for this collection

https://hdl.handle.net/1805/11716

Developmental & Relationship Contexts of Adolescent Sexual Behavior and Sexually Transmitted Infections

Mary Ott’s research examines adolescent health and development with a focus on sexual behavior, unintended pregnancy and sexually transmitted infections (STIs).

Dr. Ott started with a rigorous scientific examination of sexual abstinence as a health decision. Abstinence had become a highly politicized primary approach to reducing adolescent pregnancy, yet our scientific understanding of how adolescents made decisions about abstinence was limited. Dr. Ott’s interdisciplinary research program advances our understanding of how development, relationships and social contexts influence adolescent abstinence decisions. Four linked studies use a mix of qualitative and quantitative research methods that are drawn from psychology, sociology, anthropology, and medicine. Her research findings have been translated into practice on several levels: (1) a developmental framework for office-based counseling; (2) evaluation and improvement of Indiana RESPECT, an abstinence-focused public health education program; and (3) research findings have been directly incorporated into Society for Adolescent Medicine policy statements.

Dr. Ott’s current research is a developmental examination of how adolescent boys’ make decisions about romantic and sexual relationships, and the impact of those decisions on STIs. Results suggest important roles for families in STI prevention, and identify patterns of communication that can inform both office-based STD prevention counseling and STD prevention programs.

She has provided technical assistance and consultation in adolescent health for several community organizations. For example, focus groups with Indiana youth across the state on their health related priorities provided important youth input to the Indiana Coalition to Improve Adolescent Health for the first Indiana state health plan for adolescents.

Professor Ott’s long-term goal is to inform and improve interventions that promote healthy sexual development and prevent adolescent unintended pregnancy and STIs.

Dr. Ott’s contributions to better understanding adolescent health and decision-making is an example of how IUPUI's faculty members are TRANSLATING their RESEARCH INTO PRACTICE.

Browse

Now showing 1 - 10 of 48

Teen Pregnancy and Confidentiality
(American Medical Association, 2014-11) Ott, Mary A.; Department of Pediatrics, IU School of Medicine
Masculinity in Adolescent Males’ Early Romantic and Sexual Heterosexual Relationships
(Sage, 2015-05) Bell, David L.; Rosenberger, Joshua G.; Ott, Mary A.; Department of Pediatrics, IU School of Medicine
There is a need to understand better the complex interrelationship between the adoption of masculinity during adolescence and the development of early romantic and sexual relationships. The purpose of this study was to describe features of adolescent masculinity and how it is expressed in the contexts of early to middle adolescent males’ romantic and sexual relationships. Thirty-three 14- to 16-year-old males were recruited from an adolescent clinic serving a community with high sexually transmitted infection rates and were asked open-ended questions about their relationships—how they developed, progressed, and ended. Participants described a high degree of relationally oriented beliefs and behaviors related to romantic and sexual relationships, such as a desire for intimacy and trust. The males also described a more limited degree of conventionally masculine beliefs and behaviors. These beliefs and behaviors often coexisted or overlapped. Implications for the clinical care of similar groups of adolescents are described.
Factors influencing abstinence, anticipation, and delay of sex among adolescent boys in high-STI prevalence communities
(Elsevier, 2014-05) Cummings, Teresa; Auerswald, Colette L.; Ott, Mary A.; Department of Pediatrics, IU School of Medicine
Purpose Abstinence is a core pregnancy and STI prevention strategy. We explore the attitudinal, behavioral, and family contexts relating to abstinence and the decision to delay sex among adolescent boys. Methods Adolescent boys ages 14–17 were recruited from community sites using a venue-based sampling method. All eligible boys at venues were invited to participate in an electronic survey. Question items included sexual behaviors, attitudes related to sex, relationships, masculine values, and family contextual items. Results We enrolled 667 participants, age 15.7 years, of diverse ethnicity. 252 (38%) were abstinent. Abstinent participants were younger, less likely to report non-coital behaviors, and reported lower conventional masculine values. Among abstinent participants, 62% planned to delay sex, while 38% anticipated sex in the next year. Participants with lower conventional masculine values, and more religious or moral motivations for abstinence were more likely to plan to delay sex. Discussion Abstinence among boys is common, even in high STI risk communities. For these boys, abstinence appears to be a complex behavioral decision, influenced by demographic, behavioral, attitudinal and contextual factors such as age, race, non-coital sexual behaviors and masculine values. Understanding the attitudes and contexts of abstinence, including plans to delay sex, can inform the development of public health programs for early fatherhood and STI prevention.
Adolescent decision making about participation in a hypothetical HIV vaccine trial
(Elsevier, 2015-03-10) Alexander, Andreia B.; Ott, Mary A.; Lally, Michelle A.; Sniecinski, Kevin; Baker, Alyne; Zimet, Gregory D.; Department of Pediatrics, IU School of Medicine
Purpose The purpose of this study was to examine the process of adolescent decision-making about participation in an HIV vaccine clinical trial, comparing it to adult models of informed consent with attention to developmental differences. Methods As part of a larger study of preventive misconception in adolescent HIV vaccine trials, we interviewed 33 male and female 16–19-year-olds who have sex with men. Participants underwent a simulated HIV vaccine trial consent process, and then completed a semistructured interview about their decision making process when deciding whether or not to enroll in and HIV vaccine trial. An ethnographic content analysis approach was utilized. Results Twelve concepts related to adolescents' decision-making about participation in an HIV vaccine trial were identified and mapped onto Appelbaum and Grisso's four components of decision making capacity including understanding of vaccines and how they work, the purpose of the study, trial procedures, and perceived trial risks and benefits, an appreciation of their own situation, the discussion and weighing of risks and benefits, discussing the need to consult with others about participation, motivations for participation, and their choice to participate. Conclusion The results of this study suggest that most adolescents at high risk for HIV demonstrate the key abilities needed to make meaningful decisions about HIV vaccine clinical trial participation.
Development of a Symptom Management Intervention: Qualitative Feedback from Advanced Lung Cancer Patients and their Family Caregivers
(Lippincott Williams & Wilkins, 2017-01) Mosher, Catherine E.; Ott, Mary A.; Hanna, Nasser; Jalal, Shadia I.; Champion, Victoria L.; IU School of Nursing
Background: Little is known about cancer patient and family caregiver preferences for the content and format of nonpharmacologic interventions. Revising interventions based on patient and caregiver feedback before implementation may improve intervention feasibility and acceptability, especially in the context of advanced-stage cancer. Objectives: The aim of the study was to obtain feedback from patients with advanced-stage, symptomatic lung cancer and their family caregivers on the content and format of a nonpharmacologic symptom management intervention under development. The intervention blended evidence-based cognitive-behavioral and emotion-focused strategies to reduce physical and psychological symptoms. Methods: Semistructured qualitative interviews were conducted with 21 patients with advanced-stage, symptomatic lung cancer and caregivers. Participants reviewed handouts regarding intervention components and provided feedback. Results: Patients and caregivers desired intervention components that addressed the patient's high symptom burden such as education regarding treatment adverse effects and the provision of various coping tools. Offering interventions with a brief or flexible length and delivering them via telephone were other suggestions for enhancing intervention acceptability. Participants also preferred an equal focus on patient and caregiver concerns and a more positive intervention framework. Conclusions: Intervention preferences of patients with advanced-stage lung cancer and caregivers underscore the severity of the disease and treatment process and the need to adapt interventions to patients with high symptom burden. These preferences may be incorporated into future intervention trials to improve participant recruitment and retention. Implications for Practice: Nurses can modify interventions to meet the needs of patients with advanced-stage, symptomatic lung cancer and caregivers. For example, flexibility regarding intervention content and length may accommodate those with significant symptoms.
Adapting ethical guidelines for adolescent health research to street-connected children and youth in low- and middle-income countries: a case study from western Kenya
(Springer (Biomed Central Ltd.), 2015-12-18) Embleton, L.; Ott, Mary A.; Wachira, J.; Naanyu, V.; Kamanda, A.; Makori, D.; Ayuku, D.; Braitstein, P.; Department of Epidemiology, Richard M. Fairbanks School of Public Health
BACKGROUND: Street-connected children and youth (SCCY) in low- and middle-income countries (LMIC) have multiple vulnerabilities in relation to participation in research. These require additional considerations that are responsive to their needs and the social, cultural, and economic context, while upholding core ethical principles of respect for persons, beneficence, and justice. The objective of this paper is to describe processes and outcomes of adapting ethical guidelines for SCCY's specific vulnerabilities in LMIC. METHODS: As part of three interrelated research projects in western Kenya, we created procedures to address SCCY's vulnerabilities related to research participation within the local context. These consisted of identifying ethical considerations and solutions in relation to community engagement, equitable recruitment, informed consent, vulnerability to coercion, and responsibility to report. RESULTS: Substantial community engagement provided input on SCCY's participation in research, recruitment, and consent processes. We designed an assent process to support SCCY to make an informed decision regarding their participation in the research that respected their autonomy and their right to dissent, while safeguarding them in situations where their capacity to make an informed decision was diminished. To address issues related to coercion and access to care, we worked to reduce the unequal power dynamic through street outreach, and provided access to care regardless of research participation. CONCLUSIONS: Although a vulnerable population, the specific vulnerabilities of SCCY can to some extent be managed using innovative procedures. Engaging SCCY in ethical research is a matter of justice and will assist in reducing inequities and advancing their health and human dignity.
Coping with physical and psychological symptoms: a qualitative study of advanced lung cancer patients and their family caregivers
(Springer-Verlag, 2015-07) Mosher, Catherine E.; Ott, Mary A.; Hanna, Nasser; Jalal, Shadia I.; Champion, Victoria L.; Department of Psychology, School of Science
PURPOSE: Advanced lung cancer patients have high rates of multiple physical and psychological symptoms, and many of their family caregivers experience significant distress. However, little is known about strategies that these patients and their family caregivers employ to cope with physical and psychological symptoms. This study aimed to identify strategies for coping with various physical and psychological symptoms among advanced, symptomatic lung cancer patients and their primary family caregivers. METHODS: Patients identified their primary family caregiver. Individual semi-structured qualitative interviews were conducted with 21 advanced, symptomatic lung cancer patients and primary family caregivers. Thematic analysis of interview data was framed by stress and coping theory. RESULTS: Patients and caregivers reported maintaining a normal routine and turning to family and friends for support with symptom management, which often varied in its effectiveness. Whereas support from health-care professionals and complementary and alternative medicine were viewed favorably, reactions to Internet and in-person support groups were mixed due to the tragic nature of participants' stories. Several cognitive coping strategies were frequently reported (i.e., changing expectations, maintaining positivity, and avoiding illness-related thoughts) as well as religious coping strategies. CONCLUSIONS: Results suggest that advanced lung cancer patients and caregivers may be more receptive to cognitive and religious approaches to symptom management and less receptive to peer support. Interventions should address the perceived effectiveness of support from family and friends.
The Influence of Age, Health Literacy, and Affluence on Adolescents’ Capacity to Consent to Research
(Springer, 2016-04) Nelson, Lance R.; Stupiansky, Nathan W.; Ott, Mary A.; Department of Pediatrics, IU School of Medicine
While adults are assumed to have the capacity to consent to medical research, and young children to have no capacity, adolescents’ capacity to consent is not well described. Adapting the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), we describe adolescents’ capacity to consent to medical research and factors influencing that capacity. Our pilot study included a community-based sample of 30 adolescents, 14 to 21 years of age, who completed the MacCAT-CR after undergoing a simulated informed consent process. We found that adolescents’ capacity to consent to research was associated with age, health literacy, and family affluence. These findings suggest that investigators and institutional review boards should be aware that factors other than age may influence capacity to consent, and, for modifiable factors, such as health literacy, consent processes for medical research with adolescents can be modified.
Moral conflict and competing duties in the initiation of a biomedical HIV prevention trial with minor adolescents.
(2016-10-21) Knopf, Amelia; Gilbert, Amy; Zimet, Gregory; Kapogiannis, Bill; Hosek, Sybil; Fortenberry, J. Dennis; Ott, Mary A.; The Adolescent Medicine Trials Network for HIV/AIDS Interventions
Background: Biomedical HIV prevention research with minors is complicated by the requirement of parental consent, which may disclose sensitive information to parents. We examine the experience of principal investigators (PIs) and study personnel who faced this complex ethical issue in the first biomedical HIV prevention study that allowed minors to self-consent for enrollment. Methods: We conducted in-depth interviews with PIs and study personnel from 13 medical trial sites in cities across the United States. Data were analyzed using a conventional content analysis. Results: Participants experienced moral conflict as they struggled to fulfill conflicting duties in this trial involving minor adolescents with multiple vulnerabilities. Our participants experienced conflict between the two types of duties—protective and scientific—previously identified by Merritt. Protective duties were owed to the child, the parents, and the institution, and participants expressed tension between the actions that would protect these subgroups and the actions necessary to fulfill their scientific duties. Conclusions: Moral conflict was resolved in a variety of ways, including reflecting on the protocol's alignment with federal regulations, modifying consent language, considering each individual for enrollment carefully, and accepting institutional review board (IRB) decisions. Potential solutions for future studies are discussed, and include flexible protocol consent procedures and centralized IRB reviews.
Willingness to disclose STI status to sex partners among college-age men in the United States
(Wolters Kluwer, 2016-03) Pfeiffer, Elizabeth J.; McGregor, Kyle A.; Van Der Pol, Barbara; Hansen, Cathlene Hardy; Ott, Mary A.; Department of Pediatrics, IU School of Medicine
Disclosure of sexually transmitted infections (STIs) to sexual partners is critical to the prevention, treatment and control of STIs. We examine intra- and inter-personal influences on willingness to disclose STI status among college-age males. Participants (n = 1064) were aged 17-24 years and recruited from a variety of university and community venues. Using independent samples t-test, Pearson chi-squares test, and binary logistic regression, we examined the relationship between willingness to disclose a STI and intra- and inter-personal factors, including age, masculinity values, interpersonal violence, partner cell phone monitoring, alcohol and/or drug use, condom use, number and characteristics of sex partners, and previous STI. Results reveal that among college-age males, type of sex partner and masculinity values are significant variables in predicting whether or not an individual is willing to disclose. These data can inform STI control programs to more effectively address the complex issues associated with STI disclosure to sex partners.

Browse

Browsing Mary A. Ott by browse.metadata.dateaccessioned

Results Per Page

Sort Options